The Registry of the International Society for Heart and Lung Transplantation: 29th Adult Lung and Heart-Lung Transplant Report—2012

Functional and computed tomographic evolution and survival of restrictive allograft syndrome after lung transplantation

“…Likewise the first post-CLAD CT (3 months to 1 year after diagnosis of CLAD) and the last available CT scans during follow-up were scored. We used the term CLAD as not all patients immediately develop the typical restrictive pulmonary function defect and we aimed to describe the radiological changes starting from the moment that the FEV 1 consistently remained under 20% of the best post-operative values. Pathology reports were available when patients underwent re-transplantation, open lung biopsy or autopsy and the typical findings were previously described by Ofek et al and include extensive alveolar fibrosis, septal thickening but also obliterative bronchiolitis (7).…”

Overview of Clinical Lung Transplantation

“…Since its introduction in the early 1980s, lung transplantation has matured into a successful therapy for selected patients with end-stage lung disease, because of careful investigation into donor management, organ preservation, recipient management, and immunosuppression (Christie et al 2012). This review provides an overview of modern clinical lung transplantation and anticipated future directions.…”

Development and Validation of a Lung Transplant-Specific Disability Questionnaire

“…Other PCO measures of functioning, like ADLs, may also not be sensitive measures of change in disability. 6 Indeed, bronchiolitis obliterans syndrome (BOS) develops in 10% of patients by 1 year after transplant and 50% by 5 years. 6 While BOS is known to negatively impact both functioning and HRQL, 5 there is no observable difference in ADL disability in patients surviving 1 and 5 years after LT. 6 These data suggest that ADL-based disability analyses may substantially underestimate difficulties LT patients experience in daily life and fail to identify opportunities for future interventional studies.…”

“…Of note, too, our cohort had a greater proportion of subjects with pulmonary fibrosis than national averages. 6 It is possible, therefore, that the final items in the LT-VLA might have been different had this study been performed at other transplant centres or with a different distribution of lung diseases, for example, more persons with cystic fibrosis. In part for that reason, we elected to retain the work-related item.…”